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Advice for the New Cardiac RN

Posted

I just have been hired on a cardiac unit, and I am a new grad. I just was wondering if anyone would have advice on how to best be prepared? The unit is a telemetry unit:redbeathe.

Thanks for any help.

IHeartDukeCTICU

Specializes in CT-ICU. Has 4 years experience.

I started on a CT surgery stepdown telemetry unit when I first graduated. You'll learn alot on orientation, but you can def get a head start:

1. Know your heart anatomy and physiology, like the back of your hand.

2. Review your EKG's.

3. Review the common cardiac meds... it depends per floor (i.e. cardiac medical management or post surgical) but some of the common ones are beta blockers, calcium channel blockers, -prils, statins, digoxin, lasix, H2/PPI.

4. When you start, make yourself known... get to know everyone, introduce yourself to everyone, be courteous and friendly. I started out around the same time as some of the interns and made it a point to really get to know them and develop a rapport and now I'm in the ICU and they are residents and fellows and everything is peachy.

Sara RN

Specializes in Cardiac.

i'm also a brand new nurse. i recently started working on a cardiac intervention unit and i just love it. so far i just go into work with a positive attitude, and a willingness to learn. tare a lot of policies and procedure specific to the hospital that i'm not aware of yet so every time i come across something new i stop and find someone to ask. best of luck in your new career.

NYNurseRN

Specializes in Cardiology.

Learn the crash cart asap, what's in each drawer and the name of the medications (and what they are for ofcourse) and the instuments. Whatever isnt avalible in the cart, know where it is.

ALWAYS take a blood pressure before admin a cardiac med, I dont care if the tech took vitals 15 minutes ago, cardiac patients are unpredictable.

ALWAYS take and document a daily weight, it is the BEST indicator of Heart Failure.

Carry lots of tele stickers in your pocket.:reef:

NYLady

Specializes in CCU, L&D, Home Care, Research, Holistic. Has 30 years experience.

i'm also a brand new nurse. i recently started working on a cardiac intervention unit and i just love it. so far i just go into work with a positive attitude, and a willingness to learn. tare a lot of policies and procedure specific to the hospital that i'm not aware of yet so every time i come across something new i stop and find someone to ask. best of luck in your new career.

congratulations to both of you!

sararn has the right idea. a positive attitude and willingness to learn are essential. second to that i would advise being prepared as follows:

1. knowing where the ekg machine is located and getting familiar with doing a "stat" ekg

2. knowing where the code cart is located and reviewing your immediate "code" procedures

3. knowing the most commonly given drugs on your unit (ntg, beta blockers, heparin, diuretics, etc)

4. observe how the experienced nurses organize their day and see how do they get things done on time

:)

I love working Stepdown/Tele! I am an ER nurse but usually get floated to Stepdown or sometimes may pick up an extra shift to help out when short staffed.

Here's what I suggest:

-Know your rhythms like the back of your hand. Especially the deadly ones like Vtach/Vfib.

-Know how to read a 12 lead EKG

-Know where the EKG machine is kept and know how to take a STAT EKG because you will be doing plenty of those

-Know your cardiac drugs, like metropolol, Cardizem, Hydralazine, amiodarone, -prils.

-Know your diuretics and what to look for, example Lasix, look at K+ level

Last but not least, know where your crash cart is and what is in it!

Take an EKG class ASAP! Become ACLS certified ASAP!

Tele pts can CRASH on you really fast! You need to know how to react in case that happens.

Good luck! You will learn so much on Tele!

ORNurseAngie

Specializes in Med/surg/tele/OR.

I too just took a job in telemetry step down unit after pretty much six years of medsurg, give or take the couple years I spent as an OR nurse. I am a little nervous as this is a larger hospital than I currently work at but optimistic that I will do well. I already know how to read tele(need to learn 12 lead EKG). I already took ACLS too, so I hope I do well. It is always hard to start over though and I hope I like my new unit and new coworkers

NYLady

Specializes in CCU, L&D, Home Care, Research, Holistic. Has 30 years experience.

You won't need to learn "to read a 12-lead ECG". In fact, only someone who had completed cardiology fellowship actually "reads" an ECG (although you would be hard-pressed to get an MD to acknowledge that fact). The rest of us need basic arrhythmia detection (from the cardiac monitor) and, for those in cardiac units who will be doing 12-lead ECGs the addition of the basics of ST-elevation and ST-depression. If you learn a few additional things (T-wave inversions, BBB etc) that will be excellent and it will likely enhance your enjoyment of your job but it won't be necessary.

Edited by NYLady

i agree with NYLady you do not need to learn to read 12 leads. the best you can do is get EKG as baseline when pt admitted ot your unit and when any changes occur. always have ekg's for comparison at the ready for the MD's. you will learn to pick up a few things on 12leads after awhile but there are many subtle nuances; just know your rhythm strips and when in doubt ask a second pair of eyes. everyone gets stumped now and again.

review medications, ask for help, watch your vitals, watch your labs, watch your patients,watch your tele's, watch your step-telemetry is fast paced ha haha :heartbeat:up:

Thanks to all for the advice. I have now been on the unit for about a month, and just finished my second week on my own.:uhoh3: I am trying to give it time, but it seems very overwhelming.

CCL RN, RN

Specializes in Cath Lab/ ICU. Has 10 years experience.

You only had 2 weeks of orientation?

I have also been hired as a new grad on a caerdiac unit. Thanks everyone for the information. I'll be sure to keep everything that was said in the back of my mind when I start in a few weeks!

You only had 2 weeks of orientation?

:eek:

That's crazy!

I also will be starting on a cardiac/tele floor very soon! All the advice is very helpful! I am very excited about this opportunity :)

It's interesting that you only had orientation for 2 weeks, I feel that is alittle short, but maybe thats because you caught on so fast! I know I will need more time than that on orientation.. :)

Thanks again for the help!

tcvnurse, BSN, RN

Specializes in Thoracic Cardiovasc ICU Med-Surg. Has 15 years experience.

Two weeks of orientation for a new grad is criminal IMO. My facility has a three month period for new grads and they attend a boatload of classes including the Core Heart Center curriculum.

That said, my advice is this: treat the patient not the monitor. What you think is VTach might be someone brushing his teeth, receiving chest physio from RT, or simply tapping on the V lead. ( psych patient don't ask)

Always ask for help when you need it, even if just bouncing scenarios off another nurse. I call that 'Nursing by Committee' :)

I just got hired as a cardiac nurse!!!! I start in less than 2 weeks with orientation and classes. :) So excited...and terrified!

Question what interests folks in the Cardiac unit?